Quality Care Paradigm

8/12/2019 Quality Care Paradigm

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2007 University HealthSystem Consortium

VermochUHC PFCC Project.ppt 1

Goals of This Presentation

Participants will:

Understand the findings and conclusions ofthe Patientand FamilyCentered Care (PFCC)Benchmarking Project

Learn about effective methods for implementing thecore concepts of PFCC across the organization

Dignity and respect

Information sharing

Participation

Collaboration


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What Is PFCC?

The Institute for FamilyCentered Care (IFCC) defines*patientand familycentered care (PFCC) as:

An innovative approach to the planning, delivery, and

evaluation of health care that is grounded in mutuallybeneficial partnerships among health care patients, families,and providers.

Successfully implementing PFCC concepts requires a

major paradigm shift:

PFCC means developing collaborative partnerships withpatients and families to improve care and operationalefficiency and recognizing patients and families as equal,important members of the care team.

Source: *http://www.familycenteredcare.org/faq.html


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The IOM Supports

PatientCenteredness Health care should be based on continuous healing

relationships.

Care should be individualized.

It is important for patients to be involved in their own caredecisions.

Patients and families should have better access to information. Health care should become more transparent.

IOMs Six Aims for Healthcare Improvement are safety,patientcenteredness, efficiency, effectiveness, timeliness,and equity.

Source: Institute of MedicineCrossing the Quality

Chasm: A New Health System for the 21stCentury

Many health care professional, regulatory, and qualityimprovement organizations also support or require PFCC

concepts, e.g., AHA, Joint Commission, and ACGME


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PFCC Is a Business Decision 3 years ago MCG Health, Inc. began implementing PFCC

in neurosciences: The units Press Ganey satisfaction was at the 10th

percentile (the lowest across the medical center.) Staffmorale was poor and there were 7.5 FTE open

positions. MCG had poor market share in neuroscience.

Patient/family advisors worked with caregivers on fixingproblems, facility design, and interviewing staff, including

medical staff; every staff member signed a commitment toPFCC concepts.

Dramatic improvements were seen almost immediately


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PFCC Is a Business Decision

After implementing PFCC concepts in MCGs

Neurosciences unit:

Unit Press Ganey satisfaction = 95th percentile.

The unit has low turnover with a waiting list of quality

candidates. The unit has experienced a significant decrease in

medication errors.

MCGs neurosciences market share has increased

12% in 3 years.


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PFCCNot Just a Nice Thing to Do!

Communication problems may lead to legal action for

malpractice:*

Failing to understand patients or families perspectives

Delivering information poorly

Devaluing patient and/or family views Desertion

Source: *Beckman et al.,Archives of Internal Medicine, 1994

MCGs leaders feel that the organizations commitment to PFCC

is a significant factor in the dramatic decrease in malpracticesuits theyve experienced in recent years (see next slide).


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MCG: Favorable Trend in

Variances, Claims, and LitigationFiles, Claims, and Litigation

2001 2002 2003 2004 2005 2006 (YTD)

Years

N

umberofRecorded

Incidents

ClaimsLitigation

Files

0

10

20

30

40

50

60

70

80

90

Most UHC membersreport regular, annual

increase inmalpractice pay-outs

Source: MCG Health, Inc.


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Project Findings


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Goals of the PFCC Project

The projects steering committee focused the study on the

following key objectives:

To assist UHC members in determining their PFCCstrengths and improvement opportunities

To identify useful metrics for monitoring progress inachieving PFCC goals

To develop an aggregate database of PFCC practicesin academic health centers

To discover how organizations are successfullyimplementing PFCCs core concepts to address the

principles of quality care as outlined by the Institute ofMedicine


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Project Participation and Data Collection

26 organizations completed a PFCC survey/assessment.*

Part 1, Self-assessmenta rating of the organizationscurrent PFCC status across the entire enterprise (excludingbehavioral health and prisoner care)

Part 2, Drill-down on current practicesrespondents had the

option to respond for the entire organization or to select theunit or facility most successful in implementing PFCC

Organizations recommended by the steering committee wereinterviewed about their PFCC initiatives and practices (MCG,Vanderbilt, Washington, Colorado, Methodist, and Denver).

77 innovative strategy reports describing PFCC-relatedinitiatives were submitted.

The PFCC health care literaturewas researched.

*Many survey questions were adapted from Strategies

for PFCC: A Hospital Self-Assessment Inventory. IFCC


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Though Status Varies

All Respondents Are Engaged

In PFCC Implementation

Overall organizational PFCC status:

Have not yet begun to implement PFCC = 0% Early stages of PFCC implementation = 32%

Partial PFCC implementation in selected locations = 68%

Source: Survey Q 1 (one outlier response was trimmed)


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Disconnects Exist Between PFCC

Goals and the Efforts Made to

Achieve Those Goals 65% indicated that PFCC is part of the organizations mission

and values and 68% include PFCC goals in strategic planning,but

68% responded none or unknown for the annual budgetdevoted to supporting PFCC initiatives.

42% agreed that PFCC is part of the philosophy of care(POC), but none included patients/families in POCdevelopment.

36% reported that PFCC is included in job descriptions andperformance evaluations.

20% have created a paid patient and family leader position.

Source: Survey Qs 2, 3, 5, 12, 71, 73


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PFCC Leadership StrategiesCollaborate with patients and family advisors to:

Incorporate PFCC concepts into mission, vision, values, plans,safety initiatives, philosophy, and scope of care for each area

Create and describe a paid patient and family leader position(supported by appropriate budget and resources) and with primaryresponsibility for overseeing, coordinating, and implementing PFCC

initiatives across the enterprise

Select leaders and providers who practice PFCC concepts, e.g.,outsourced service/equipment vendors, administrative leaders, andcaregiversincluding medical staff

Leaders must believe in and practice PFCC concepts and act asrole models for the organization

Hold staff and vendors accountable by including PFCC goals in jobdescriptions, evaluations, credentialing procedures, and contracts

Source: UHC PFCC project


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PFCC Core Concept:

Dignity and Respect

Dignity and Respect:

Health care practitioners listen to and honor patient andfamily perspectives and choices

Patient and family knowledge, values, beliefs, andcultural backgrounds are incorporated into the planningand delivery of care*

Source: *The Institute for Family

Centered Care

Methodists International Department includes speakers of 12languages and represents 14 ethnicities to improvecommunication and assist in understanding cultural concerns and

enhancing the care experience for patients and families.

Digni ty and

Respect


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Dignity and Respect:

Improvement Opportunities

64% agreed that effective processes are in place to ensurepatients/families are greeted in a friendly manner.

52% agreed that the ethnic/cultural diversity of staff isconsistent with the patient populations served.

40% agreed that the facility offers a healing, supportive dcor.

40% agreed that conversations about patients are conductedaway from public areas.

52% agreed that confidential registration discussions areheld in private locations.

32% agreed that care settings provide privacy.

Source: Survey Qs 22, 24, 30, 31, 36, 46


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PFCC Dignity and

Respect Strategies

Partner with patients and family advisors to: Put effective processes in place to ensure all staff and

employees always introduce themselves to the patient andfamily and explain their roles in his/her care

Implement friendly policies and procedures that respect thecultural and lifestyle needs of patients and families

Implement practices to encourage family participation in thecare team and endure that other team members listen to andrespect their opinions

Put organization-wide practices in place that are designed toprovide patient/family privacy and respect confidentiality

Fairview Childrens Hospital has open visitation and

digital camera technology is used to create pictureID badges for parents, who are viewed as equal

members of the care team.


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PFCC Core Concept:

InformationSharing

Information Sharing:

Health care practitioners communicate and sharecomplete and unbiased information with patients and

families in ways that are affirming and useful

Patients and families receive timely, complete, andaccurate information to allow them to effectivelyparticipate in care and decision making

Source: The Institute for Family Centered Care

Information

Shar ing


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Paper Records Are Common and

May Hinder Patient, Family,

and Provider Communications

Medical Record Format Inpatient Outpatient ED

Primarily electronic 8% 12% 25%

Primarily paper 12% 28% 29%

Partially electronic/partially paper 80% 60% 46%

Source: Survey Qs 93, 94, 95, 96

31% of survey respondents offer few or no electronic systems for patients and

families but Duke, UAMS, MCG, Oregon, OSU, Vanderbilt, Colorado, andothers have invested in electronic systems that offer patients and families manycommunication options and resources, e.g., personal health information, testresults, education, scheduling and registration, billing, e-mail providers.


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Not All Are Compliant With Joint

Commission Safety Requirements for

Error Communication and Reporting 88% have a standard procedure in place to communicate errors,

near misses, and adverse events to patients/families.

84% have a process in place for patients and families to reportsafety concerns consistent with National Patient Safety Goal 13(Patient Involvement)

Source: Survey Qs 98, 99

Vanderbilts patient safety initiatives are strongly aligned with PFCC goals;separate communications and educational programs were designed (with

advisor input) for both staff and patients/families e.g., patient identificationDenver Health discovered that 80% of errors were due tomiscommunication; theyve incorporated PFCC goals into improvement

initiatives to increase safety


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Confidentiality Is Not New!

HIPAA regulations do not prevent sharing personal healthinformation with patients and families (in accordance withpatient preferences).

Organizations that have made a strong commitment to

PFCC are also bound by HIPAA regulations and havelearned how to respect confidentiality and promoteinformation sharing.

Put processes in place to provide privacy and protect

confidentiality and train staff and patient/family advisors torespect these conceptsthen monitor compliance and holdthem accountable.


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PFCC Information Sharing StrategiesPartner with patients and family advisors to:

Encourage patients and families to dialogue, share information,and embrace their roles as members of the care team, includingparticipation in rounds, goal-setting, safety, and care decisions.Provide patients and families with easy access to educational andpersonal health information and the medical record.

Implement electronic systems to facilitate communication,information sharing, and education.

Routinely follow-up with patients/families to ensure that careinstructions were understood and if additional support is needed.

Colorados Diabetes Star Web system offers access to personal healthinformation and guides patients in goal setting.At OSUs Ross Hospital, patient relations staff and nurse managers conductproactive rounds to meet patients and families, encourage communicationand participation, and identify and address concerns and complaints quickly.



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PFCC Core Concept:

Participation

Participation:

Patients and families are encouraged and supported inparticipating in care and decision-making at the level theychoose

The caveat at the level they choose above indicatesthat flexible care systems must be in place that can beadjusted as needed according to patient and familypreferences (e.g., family preference for remaining withthe patient during a code).

Only 35% of survey respondents agreed that flexiblecare delivery systems are in place to accommodatepatient and family preferences.

Sources: The Institute for Family Centered Care

and Survey Q 6

Participation


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Patients and Families Have Limited

Opportunities for Presence or

Participation in RoundsIn accordance with patient preferences:

Families remain with inpatients: Inpatients/Families participate in:

General care rounds = 85% General care rounds = 50%

Critical care rounds = 62% Critical care rounds = 35%

End-of-life care rounds = 62% End-of-life care rounds = 54%

ED rounds = 31% ED rounds = 15%

Not allowed to remain = 8% Not allowed to participate = 23%

58% of respondents have no process in place to accommodate familyschedules but at UH Cases Rainbow Babies and Childrens Hospital, if families

cannot be present during rounds then the attending, fellow, bedside nurse, andcharge nurse round with families when they arrive.

Source: Survey Qs 83, 83a, 84, 85, 85a


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Room Design and Visitation Policies

Often Dont Provide Privacy, Family

Sleep Space, or Access to Inpatients Total staffed inpatient

acute care rooms that

are private rooms:

Median = 50%

Mean = 52%

Minimum = 5%

Maximum = 100%

Inpatient rooms with family

sleep space:

Median = 10%

Mean = 35%

Minimum = 0%

Maximum = 100%

31% dont provide family sleepspace in critical care units


Only 12% of respondents strongly agreed that families have

24/7 access to inpatients


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PFCC Core Concept:

Collaboration

Collaboration:

Patients, families, health care practitioners and hospitalleaders collaborate in:

Policy and program development

Implementation and evaluation

Health care facility design

Professional educationThe delivery of care

Source: The Institute for FamilyCentered Care

Collaborat ion


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Only Half of Respondents Have

Patient/Family Advisory Councils

It is essential for caregivers to collaborate with patients andfamilies at all levels of the organization. Each group contributesunique perspectives and experiences important to shapingorganizational policies, programs, practices, and facility design.

52% of survey respondents have functional patient/familyadvisory councils in place.

Of these, 77% include the regular participation of seniorleaders.

Source: Survey Qs 74, 75

But


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Some Organizations Have

Developed Collaborative Partnerships

with Patients and Families At Duke, patient/family advisors participate on more than 15

organizational committees and other initiatives.

At Vanderbilt patient/family advisors accompany senior

executives on rounds and they also act as secret shoppersreporting on their service experiences.

MCG wont bid out construction jobs until patient/familyadvisors have signed off on the blueprints.

At Washington patient and family advisors on the aestheticscommittee regularly provide feedback on facility environmentand design.

36% of respondents agreed that patient andfamily advisors participate in facility design.

Source: UHC PFCC

project and survey Q 101


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Effective Patient/Family Advisors Ask doctors, nurses, and other staff for recommendations and

put notices hospital and newspapers to find potential advisors.

Look for individuals who have a genuine interest in improvingcare but without a strong personal agenda or an axe to grind.

Candidates must be carefully interviewed and trained asvolunteers (including safety, HIPAA, and confidentiality training).

Most project participants dont pay advisors but they may offer ateaching stipend and other perks, e.g., free parking, meals, ortickets to university sporting events.

Some organizations set a time limit/term for advisor participation

while others find that there is a natural attrition process. It is essential to also train staff to successfully work with advisors

to achieve mutual improvement goals.

Washington pairs advisors with committee membersfor follow-up, advice, and to answer questions.


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PFCC Is Not Often Included in

Health Care Education and Patients/

Families Rarely Serve as PFCCTeachers PFCC principles are included in

curriculum:

Nursing = 50%

School of medicine = 27% Allied health = 23% Dental = 8%

Patients/families participate asfaculty in orientation/education:

15% of employees 12% of volunteers 8% of temporary staff and

students/trainees 8% of medical staff 4% of trustees

Source: Survey Qs 9, 78, 79

Only 19% of surveyrespondents agreed that

patient and familyadvisors helped to

develop patient, family,and staff PFCC

educational materials


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Patients and Families

Rarely Collaborate in

Provider Selection Practices 8% invite patient/family advisors to interview clinical and

administrative leaders.

4% ask patient/family advisors to help in the selection ofresidents.

4% include patient/family advisors in selecting outsourcedservice and equipment vendors.

16% indicated that processes are in place to ensurethat outsourced service and equipment vendorspractice PFCC principles.



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PFCC Collaboration Strategies

Partner with patients and family advisors to:

Develop a functional patient/family advisory council(s) thatmeets at least quarterly, includes senior leaders, and makesrecommendations to the leadership

Design a healing, supportive environment that encourages

family presence/involvement-including family resource centers,sleeping spaces, training labs, and easily understood signage

Develop understandable educational materials and includepatients and families in training programs designed for patients,families, and staff

Select leaders and providers who practice PFCC concepts, e.g.,outsourced service/equipment vendors, administrative leaders,and caregiversincluding medical staff



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PFCC in Ambulatory Care and

Business Office Practices


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PFCC and Ambulatory Care

Most PFCC-initiatives are focused on inpatient care units

- Primarily in maternal and child care and end-of-life care

In ambulatory care, PFCC care concepts are most likely to beimplemented in selected settings such as pediatric oroncology clinics

A study* evaluating the affects of PFCC on outpatient visitsconcluded that when patients and doctors find commonground:

Physical health status improved

Emotional health improved Fewer referrals and diagnostic tests were needed two

months after the visit

* Source: Stewart, et al. The Impact of Patient-Centered

Care on Outcomes, Journal of Family Medicine, 2000


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PFCC and the Business Office

Self-assessment and survey data revealed many

opportunities to implement PFCC concepts in non-clinicalareas:

Registration, scheduling, and access to services, e.g., theneed for simple, consistent, and confidential registration

and scheduling procedures; convenient access toservices; coordinated support during scheduling and caretransition, etc.

Finance, charge, billing, and payment procedures, e.g., the

need for consistent, easy and convenient practices (simplelanguage, combined copay, flexible, online paymentoptions, etc.)

See appendix for survey data


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PFCC Performance Measures:

Self-Assessment Scores,Satisfaction Surveys, and Other

Outcomes Measures


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Much PFCC Improvement Is Needed

in Every Area Evaluated

Self-Assessment Topics Mean

Leadership -0.1

Patient and family involvement 0.2

Communications 0.2

Environment/facility and patient/family support 0.0

Scheduling and registration -0.1

Finance, charge, and payment practices 0.1

Billing practices -0.1

*Scoring:Strongly agree = 1.0Agree = 0.5

Neutral = 0.0Disagree = -0.5Strongly disagree = -1.0Average score: sum ofscores divided by thenumber of responses

Average PFCC Self-Assessment Scores

(Maximum Possible Score = 1.0*)

Source: Survey Qs 2 through 67

Many felt that the self-assessment process wasbeneficial; getting keystakeholders to discuss theissues is eye-opening.None of the respondents

achieved the maximumscore in any PFCC topic.


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Measures Most Commonly Used

by Respondents

to Monitor PFCC Performance Vendor surveys (national

benchmarks):

92% Inpatient

58% Outpatient Internal surveys (internal

benchmarks) :

54% Inpatient

38% Outpatient 4% Patient satisfaction not

measured

Complaint Process:

73% Inpatient

65% Emergency department

54% Outpatient

Other outcomes measures:

65% Employee turnover

65% Length of stay

62% Fall rates

54% Errors

42% Financial measures

Source: Survey Q 113


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PFCC Satisfaction Scores Show

Improvement Opportunities

18 organizations that participate in Press Ganey Adult InpatientSatisfaction Surveys submitted their most recent scores for keyPFCC questions:

Explanation of tests and treatments

Information given to family about condition and treatment

Instructions given for care at home

Inclusion in treatment decisions

Nurses kept you informed

Physicians concern for questions and worries

Average PFCC scores were calculated: 4 organizations (22%): > 85.0 (range 85.2 to 88.5)

10 organizations (56%): > 80.0 and < 85.0 (range 81.0 to 84.6)

4 organizations (22%): < 80.0 (range 76.5 to 79.4)

Source: Survey Q 115


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New Press Ganey PFCC MeasuresUHC members using PG surveys are encouraged to use these

new questions to evaluate and benchmark PFCC practices Effective March 2006 Press Ganey added PFCC custom

questions to all 13 PG survey instruments:

How well staff explained their roles in your care

Degree to which the staff supported your family throughoutyour health care experience

Degree to which your choices were respected to havefamily members/friends with you during your care

Degree to which you and your family were able to

participate in decisions about your care

Degree to which staff respected your family's cultural andspiritual needs

Source: Press Ganey PFCC Metrics Task Force

(including a Univ. of Washington representative)


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HCAHPS Measures HCAHPS measures that may be used as indicators of patient-

centeredness for UHCs key organizational reports: How often did nurses treat you with courtesy and respect?

How often did nurses listen carefully to you?

How often did nurses explain things in a way you could

understand? How often did doctors treat you with courtesy and respect?

How often did doctors listen carefully to you?

How often did doctors explain things in a way you couldunderstand?

Using any number from 0 to 10, where 0 is the worst hospitalpossible and 10 is the best hospital possible, what numberwould you use to rate this hospital?


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PFCC Measurement Strategies Establish, evaluate, and routinely monitor PFCC performance

measures

Regularly collect complaint and customer satisfactioninformation in all care settings, including comparativeexternal satisfaction benchmarks versus other providers

Work with patients and families to review data, identify

opportunities, and design, implement, and monitor performanceimprovements

It may be difficult to discuss satisfaction data with patientsand families but this is essential to better understand the

information and create solutions that will successfullyaddress patient and family needs

The Institute of Medicine endorses transparency in healthcare organizations to improve quality and safety


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Project Conclusions Many PFCC improvement opportunities exist in the areas of:

Leadership Patient and family involvement in strategic planning,

operations, and care delivery

Communications and information sharing

Facility design Support and resources for patients and families

Education of patients/families and staff

Scheduling, registration, access, care transitions, and

charge, billing, and payment practices

Many other aspects of service and care delivery

All project participants have improvement opportunities


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The Most Important Take-Aways

From This Study

Patients and families are important, equal members of thecare team and have the right to participate in decisionsaffecting the planning, delivery, and evaluation of care.

Dont assume that you understand and can effectively address

patient and family needs and concerns without sharing thedata, asking their opinions, and involving them in designingsolutions to create a friendlier, more effective, efficient, andsafer health care organization.

The doctors and nurses focus on my physical health and on treatingmy condition and thats very important, but quality of life is also very

important to me and they dont always think about that.

Terry H, MCGs Neurosciences Patient/Family Advisory Council


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PFCCNot Just a Nice Thing to Do! Blue Shield of California conducted an 18-month study of 756 HMO

members (all with late-stage illness and access to the same

benefits and provider network). Half were blindly assigned toreceive usual case management (UCM) and half received patientcentered management (PCM) including working with a caremanager to develop goals based on disease state, treatmentoptions, pain management, and end-of-life decisions. Survival rates

were the same for both groups; the study concluded that PCMeffectively reduced overall costs by 26%:

$18,000 cost reduction per patient

Hospital admissions reduced by 38%

Hospital days reduced by 36%

Emergency room visits reduced by 30% Home care use increased by 22%

Hospice use increased by 62%

Higher satisfaction rates for 92% of the PCM members

Source: LSweeney, et al,The American Journal of

Managed Care, Feb 2007


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Implement PFCC Concepts Through

Partnerships With Patients and Families

Dignity and Respect:Health care practitioners listen to and honorpatient and family perspectives and choices. Patient and familyknowledge, values, beliefs, and cultural backgrounds are incorporatedinto the planning and delivery of care.

Information Sharing: Health care practitioners communicate and

share complete and unbiased information with patients and families inways that are affirming and useful. Patients and families receive timely,complete, and accurate information to allow them to effectivelyparticipate in care and decision making.

Participation:Patients and families are encouraged and supported inparticipating in care and decision making at the level they choose.

Collaboration: Patients, families, health care practitioners, andhospital leaders collaborate in policy and program development,implementation and evaluation; health care facility design; professionaleducation; as well and in the delivery of care.

Source: The Institute for Family Centered Care


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Where To Start? Begin partnering with patients/families to implement PFCC

concepts in locations that make sense for your organization:

Maternal/child services because family participation is expectedand natural

Units with the greatest opportunity to improve customersatisfaction

Locations with the greatest opportunity to improve safety Units with a PFCC champion who is receptive to change

Construction projects that bring key stakeholders together

Share PFCC success stories and work with others to foster andimplement a PFCC culture across the organization

PFCC applies to every facet of health careinpatient, outpatient,ED, ancillary, home care, hospice, behavioral, subacute/long-term care, scheduling, registration, billing, support services,outsourced vendors, etc.


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PFCC Advice for Beginners

Stories change culture; ask patients, families, and staff to

share their (positive and negative) health care experiences.

Senior leadership buy-in is essential to provide role modelsand resources, and to hold staff accountable for practicingPFCC concepts.

Select PFCC performance measures (including safetymeasures), collect baseline data, monitor performance,and then share the results.

Look for early adopters and work with them to successfullyimplement PFCC concepts and help others to learn fromtheir example.

Continued...


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PFCC Advice For Beginners

Help staff confront their fears about patient and family

presence, participation, and collaboration by starting smalland working with one unit. Show staff the data and provideexamples of other AMCs that have implemented PFCCconcepts. Prepare staff to deal with a variety of issues andscenarios through training and scripting.

Recruit a physician champion(s) to convince other doctorsthat PFCC doesnt deter medical education, it enhances

learning. Incorporate PFCC concepts into educationthrough the use of patient/family advisors as faculty intraining doctors, caregivers, and other providers.

Constantly ask have we gotten patient/family input on this

plan? before moving forward to implement changes.


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Next Steps

Review project materials* to identify 1 or more best practices that yourorganization will implement:

1. Network with colleagues who are successful in this area tounderstand their practices and processes.

2. Identify/organize a team that includes all key stakeholders includingphysician champions, senior leaders, and patient and family advisors.

3. Formulate an improvement plan based on relevant data, withresources focused on your priorities.

4. Implement the plan.

5. Monitor changes and report results throughout the organization.6. Share your success stories with others in your organization and with

your UHC colleagues to help them to improve.

*All project materials will be available on the UHC Web site atwww.uhc.edu; select Improvement & Effectiveness,

Benchmarking, and Patient-and Family-Centered Care.

Implementat ion

PFCC I l t ti C ll b ti


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PFCC Implementation Collaborative UHC is currently enrolling members in a PFCC implementation

collaborative (due June 1st). Participant will work in any/all of 3

work groups to implement improvement strategies related to: Patient and family participation in care

Patient and family advisors and councils

Special PFCC initiatives (ambulatory/non-acute care, business office,PFCC measures, etc.)

Members can take part in any/all workgroups at no charge;participation in the original project is not required.

Implementation Support Project process:

Members enroll and identify executive sponsor, team leader,team members, and select performance goals and measures

Monthly networking conference calls for 6 months with teamleaders of all organizations enrolled in the work group

Web conference to present strategies and learnings

Field Brief document summarizing work done by workgroups


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PFCC Project Deliverables*

Survey results

Project results and findings Knowledge transfer presentations/Web conferences

Compendium of Innovative Strategy reports

Performance Opportunity Summary/Scorecard

Field Book, Executive Summary, and Action Plan

UHCs PFCC listserver, providing a networking forum for members

UHC PFCC Implementation Support Collaborative (enroll by 6/1)

Also see the many PFCC resources, assessments, and training

materials available from the Institute for Family-Centered Care athttp://www.familycenteredcare.org/index.html.

*All project materials will be available on the UHC Web siteat www.uhc.edu; select Improvement & Effectiveness,Benchmarking, and Patient-and Family-Centered Care.

Th S f B h ki


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The Success of Benchmarking

Comes From Implementation,

Not the Data

Digni ty and

Respect InformationShar ing

Part ic ipat ion Collaborat ion

Implementat ion

For more information about the UHC Patient-and Family-Centered Care Project contact Kathy Vermoch [email protected] or 630/954-1030


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Appendix

There Are Many Opportunities to


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There Are Many Opportunities to

Improve Scheduling, Registration,

and Access to Services 36% agreed that scheduling and registration procedures areconsistent across the organization.

28% agreed that patients complete the full registration processwhen appointments are scheduled.

24% indicated that online registration is available. 20% reported that business hours for scheduling appointments

include off-hours, e.g., weekends and evenings.

8% agreed that commonly requested appointments are availableduring off-hours, e.g., weekends and evenings (12% agreed that

commonly requested ambulatory and ancillary appointments areavailable within 2 weeks).

4% included patient/family advisors in the design of scheduling andregistration procedures and materials.

Source: Survey Qs 37, 39, 41, 42, 44, 47, 51

Ch Billi d P t PFCC


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Charge, Billing, and Payment PFCC

Improvement Opportunities Exist

28% agreed that easy-to-understand, patient-friendlydescriptions are used on billing statements.

24% indicated that patients are able to pay a single copay forservices provided by multiple departments.

16% reported that patients receive a combined billingstatement for services provided by multiple departments.

16% stated that billing statements are available in the primarylanguages of the communities served.

12% agreed that patient/family input is used to design andenhance billing statements and other communications.

8% reported that patients/families are able to check accountsand pay bills online.

Source: Survey Qs 55, 60, 64, 65, 66, 67

PFCC S h d li R i t ti


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PFCC Scheduling, Registration,

and Billing Strategies

Partner with patients and family advisors to: Design and implement simple, consistent, and confidential

registration and scheduling procedures with convenient accessto services and coordinated support during scheduling andcare transition

Implement consistent finance, charge, billing, and paymentpractices that are easy and convenient for patients andfamilies, e.g., simple language, combined copay, flexible,online payment options

Regularly obtain feedback on billing statements to make surethey make sense and are easy-to-read

I t ti l C f PFCC


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VermochUHC PFCC Project ppt 59

International Conference on PFCC

Partnerships for Enhancing

Quality and Safety

Jul 30 - Aug 1, 2007

Seattle, WA

With leadership support

from Children's Hospital &Regional Medical Center,University of WashingtonMedical Center, and SeattleCancer Care Alliance

http://www.familycenteredcare.org/index.html

Documents

Quality Care Paradigm